Pang T, Guo X F, Zhou Y H, Qiu X Q, Li S, Liang Z R, Qin X L, Li K H, Zeng X Y
Department of Epidemiology and Health Statistic, School of Public Health, Guangxi Medical University, Nanning 530021, China.
Department of Maternity, Pingguo County Child Health, Baise 531400, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2017 Dec 10;38(12):1620-1623. doi: 10.3760/cma.j.issn.0254-6450.2017.12.007.
To investigate the association between the value of α-thalassemia minor and the outcomes in pregnant women. A total of 445 pregnant women with α-thalassemia minor were selected as thalassemia group in the Pingguo County Maternal and Child Health Hospital of Guangxi from January 2011 to December 2015, with ratio of 1∶4 healthy pregnant women was randomly recruited as non-thalassemia group. Clinical characteristics and pregnancy outcomes of the two groups were retrospectively analyzed using methods including test, (2) test, and logistic regression model and ROC curve. There were no significant differences noticed in factors as age, BMI, gestational age and educational level of the two groups. Hemoglobin of the thalassemia group was significantly lower than that of the non-thalassemia group (<0.001). Differences on parity, ethnicities or occupation were statistically significant. Results from univariate analysis showed that the proportions of low birth weight, small for date infant and 1 min Apgar score<7 were higher in the thalassemia group, but the ratio of adverse pregnancy outcomes was comparable on parameters as preterm birth, stillbirth, macrosomia. Findings from the unconditional logistic regression showed that pregnancy complicated with α-thalassemia minor appeared a risk for both newborns with low birth weight (a=2.29, 95%: 1.32-3.95) and small for date infant (a= 2.11, 95%: 1.16-3.84). The ROC curve showed that α-thalassemia minor combined with multiple indicators presented a certain predictive value on neonatal birth weight. Pregnancy complicated with α-thalassemia minor was likely to increase the risk of birth weight loss in newborns, suggesting that prenatal care for pregnant women with thalassemia be strengthened, in order to reduce the incidence of adverse pregnancy outcomes.
探讨轻型α地中海贫血孕妇相关指标与妊娠结局的关系。选取2011年1月至2015年12月在广西平果县妇幼保健院就诊的445例轻型α地中海贫血孕妇作为地贫组，按照1∶4的比例随机抽取健康孕妇作为非地贫组。采用检验、检验及logistic回归模型、ROC曲线等方法对两组孕妇的临床特征及妊娠结局进行回顾性分析。两组孕妇在年龄、BMI、孕周及文化程度等方面比较，差异无统计学意义；地贫组孕妇血红蛋白水平明显低于非地贫组（<0.001）。两组孕妇在产次、民族、职业方面差异有统计学意义。单因素分析结果显示，地贫组低出生体重儿、小于胎龄儿及1分钟Apgar评分<7分的比例均高于非地贫组，而两组在早产、死胎、巨大儿等不良妊娠结局方面差异无统计学意义。非条件logistic回归分析结果显示，妊娠合并轻型α地中海贫血是新生儿低出生体重（a=2.29，95%CI：1.32-3.95）及小于胎龄儿（a=2.11，95%CI：1.16-3.84）的危险因素。ROC曲线分析结果显示，轻型α地中海贫血联合多项指标对新生儿出生体重具有一定的预测价值。妊娠合并轻型α地中海贫血可能增加新生儿出生体重降低的风险，提示应加强对地贫孕妇的孕期保健，以降低不良妊娠结局的发生。
